Trauma & Turnover: State Mental Health Hospital Investigation

The South Dakota Human Services Center in Yankton is shown on June 3.

Joe Ahlquist / Argus Leader

Mark Walker |
mwalker@argusleader.com

11:48 am CDT October 20, 2016

South Dakota's state-run mental health hospital in Yankton has experienced a rise in patient violence against employees in three of the last four years. Workers at the Human Services Center are now nearly twice as likely to file workers' compensation claims as state prison employees, an Argus Leader Media investigation found.

Current and former employees said state officials haven't done enough to address security problems at the hospital, and that the patient assaults have played a role in rising turnover and staffing issues. The hospital's new administrator said he intends to address staff security and morale issues in his first six months on the job.

May 22: Patient attacks take toll on state mental hospital
An Argus Leader Media investigation found a steady rise in violence toward doctors, nurses, and other Human Services Center employees. The assaults have left workers with broken bones and concussions, fueled a wave of resignations and left remaining staff exhausted, demoralized and fearing for their safety.

May 23: Lawmakers, advocates react to investigation
South Dakota lawmakers say they will seek solutions and recommendations to the high employee turnover and safety concerns. Sen. Deb Peters, R-Hartford, said the problems will be discussed by the Government Operations and Audit committee.

May 24: Gov. interested in 'areas to improve' state hospital
South Dakota Governor Dennis Daugaard said he's interested in a conversation about "areas to improve" the state-run hospital. He declined an interview but in a brief email statement said all state institutions should seek self-improvement and that he was looking forward to talking with the hospitals' new administrator.

May 29: Ex-employees recall trauma at mental hospital
A mother and daughter share their stories about witnessing and experience violence inside the hospital, where they both worked until this spring. "It wasn’t worth my life. It wasn’t worth the benefits. It wasn’t worth the money," said Christina Arroyos, a former mental health technician at the hospital.

May 29: State mental hospital misused restraints on patients
The Human Services Center violated patients' rights by misusing restraints to control potentially unruly subjects, a federal inspection found. Employees excessively used restraints and failed to document the reasons for placing them on patients, according to the Centers for Medicare and Medicaid Services.

June 5: Feds: Head nurse at state hospital lacks credentials
The Human Services Center's head of psychiatric nursing doesn't have the necessary degree for the job, according to the Centers for Medicare and Medicaid Services, which flagged the manager's lack of training and education credentials earlier this year among dozens of other problems at the facility.

June 5: State hospital administrator plans to address problems
The hospital's new administrator said he will address employee morale, turnover and safety issues in his first six months on the job. “Give me an opportunity to get the facility where the staff feels it needs to be, where the lawmakers feel it needs to be, and where the community feels it needs to be,” Troy Jones said in his first interview.

June 12: Pay, staff support key to rebuilding mental hospital
The state hospital in Yankton is the last stop for patients who can’t function in a less-restrictive setting, yet the people who work there make less money than the national average, less than their counterparts in other states and often less than employees who do similar work in the private sector. That will be true even after the pay raise approved by the South Dakota Legislature this year.

June 19: Feds find fault for boy's death at state hospital
A series of mistakes by staff at South Dakota's state-run mental health hospital contributed to the suicide of an adolescent boy in 2014, according to a report by federal inspectors who arrived in Yankton in the days following the death.

An inspection by the Centers for Medicare and Medicaid Services found the Human Services Center in Yankton failed to protect and promote patient's rights.

Argus Leader Media

June 19: States turn to former patients to fill mental health gaps
In at least 30 states, including Iowa, Minnesota, Nebraska and North Dakota, former mental health patients are being trained to help fill workforce gaps and improve care under a new certification known as peer support specialists. The model offers a possible solution to staffing problems at the state's mental health hospital in Yankton.

June 26: Death records reveal 82 patients died at state hospital
A review of death certificates shows dozens of patients at South Dakota's state-run mental health hospital have died in recent years, usually of natural causes. A records search reveals 82 deaths at the Human Services Center in Yankton — about one per month — since July 2009. They included one suicide and four accidental deaths related to falls.

Argus Leader reporter Mark Walker spoke with Gov. Dennis Daugaard about working conditions at the Human Services Center in Yankton.

June 28: Daugaard says he'll call on private group to help HSC
Gov. Dennis Daugaard said he'll bring in a quality assurance officer from the Children's Home Society to monitor South Dakota's state-run mental health hospital. Daugaard previously worked as the Children's Home Society's executive director.

All patients coming into the South Dakota Human Services Center in Yankton will be asked to change into hospital-type scrubs and go through an orientation upon arrival, under a new policy intended to better protect staff.